It is very easy to feel judgmental in this situation. From my experience, it is likely that the woman will actually be quite upset. We must remember God's love for her, despite the apparent attitude she has towards her unborn baby. God loved us even when we were still sinners.[1] However, all of us will be called to give account of our actions.[2]

During the consultation, my aim would be to support the patient as she and her partner make a difficult decision. It is important to present them with all the options available, as well as helping them to think through the consequences of whatever decision they make. This is something many doctors fail to address. Informed consent is all important but in the area of abortion doctors often react by trying to make their involvement as short as possible.

As a Christian I would approach the consultation having already decided not to be involved in the process of termination because I believe it to be wrong.[3] Abortion is the killing of innocent life created by God in his image.[4] My hope would be that I could help the couple find a solution that does not involve taking the life of the unborn child. I must decide how far to push the rights of the unborn child, but at the same time I need to show compassion and respect for the mother.

If she came alone I would suggest that she came back with her boyfriend so that both partners could be involved in the decision. I would ask why the couple do not feel able to cope with a third child. If they were given help to cope would they want to continue with the pregnancy? If this is the case, there are several options that might help them.[5] If not, I would ask them what they knew about termination of pregnancy. I could then ask them how they felt about the baby: had they thought about what/who was being terminated? Hopefully the couple would be able to open up about why they had decided on a termination. It might be worth asking them if they have considered adoption as an alternative before outlining the procedures and consequences involved in both options. It is important to remember that the lifetime risk of psychological morbidity following an abortion is greater than 10%.[6] There is also a breast cancer risk.[7] It is important to present the advantages and disadvantages of both abortion and adoption without allowing your own beliefs to prejudice the information. You must show understanding, whilst at the same time listening to the couple and allowing them to express their feelings.

If they decided to go ahead with the termination, I would explain that I would not be able to refer them for the procedure because, as a Christian, I believe it to be wrong. This statement alone is really important. Gently saying, 'I don't believe it is right' against a background of giving time and consideration is a crucial part of a Christian showing saltiness in such a situation.[8] If they wanted to discuss my position further I would explain more fully. I would also say that although I did not agree with abortion, I wanted to support them and help them through this difficult time and that I hope they would feel free to come back at any time if they needed support or someone to listen.

The options then are whether to ask her to see another doctor, to ask another doctor in the practice to see her yourself, or to send a referral letter to a gynaecologist requesting their opinion about whether a termination would be justified. In the latter case you could state that you see no grounds under the Abortion Act and not sign the abortion referral form. I know some Christian doctors who do refer and sign this form. However, I think that if I were to do this my actions would undermine my words.

Thank you to Elizabeth Paine, 2nd year student at the Royal Free and University College Medical School, for her significant contribution to this column.